Organization
J. DON JACKSON JR, MD, PA
Active
Other names
ADVANCED SURGERY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES DON JACKSON JR. MD, PA (PHYSICIAN)
(903) 723-8210
Entity
Organization
Contact information
Practice address
300 WILLOW CREEK PKWY, SUITE 200 A, PALESTINE, TX 75801-4421
(903) 723-8210
(903) 723-8310
Mailing address
P O BOX 817, PALESTINE, TX 75802
(903) 723-8210
(903) 723-8310
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178962001
—
TX
Enumeration date
01/16/2007
Last updated
10/04/2010
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